Fri May 13 2022

97 articles - From Friday May 06 2022 to Friday May 13 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Endoscopy

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2022.

ESGE recommends that, after an endoscopically complete resection, if there is a positive horizontal margin or if resection is piecemeal, but there is no submucosal invasion and no other high risk criteria are met, this should be considered a local-risk resection and endoscopic surveillance or re-treatment is recommended rather than surgery or other additional treatment. ESGE recommends that when there is a diagnosis of lymphovascular invasion, or deeper infiltration than sm1, or positive vertical margins, or undifferentiated tumor, or, for colorectal lesions, budding grade 2 or 3, this should be considered a high risk (noncurative) resection, and complete staging and strong consideration for additional treatments should be considered on an individual basis in a multidisciplinary discussion. ESGE recommends scheduled endoscopic surveillance with high definition white-light and chromoendoscopy (virtual or dye-based) with biopsies of only the suspicious areas after a curative ESD.

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Meta-analysis

meta-analyses and systematic reviews

Clin Gastroenterol Hepatol

Fibrosis-stage Specific Incidence of Hepatocellular Cancer after Hepatitis C Cure with Direct-Acting Antivirals: A Systematic Review & Meta-analysis.

Pooled HCC incidence after SVR in patients with cirrhosis was very high (2.99/100 person-years), but may be declining as longer time accrues after SVR. In patients without cirrhosis, including F3 fibrosis, HCC incidence was lower than thresholds associated with cost-effective HCC screening. In patients with F3 fibrosis, the lack of between-study heterogeneity provides strong evidence that HCC screening may not be warranted.

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Mortality Outcomes by Fibrosis Stage in Non-alcoholic Fatty Liver Disease. A Systematic Review and Meta-Analysis.

Stage 3-4 fibrosis had a higher all-cause (HR 3.32) and liver-related mortality (HR 10.40) compared with stage 0-2 fibrosis, while stage 4 fibrosis had higher all-cause (HR: 2.67, CI:1.47-4.83) and liver-related mortality (HR 2.57, CI:1.22-5.42) versus stage 3 fibrosis. Risk of all-cause and liver-related mortality increases substantially with fibrosis stage. These data have important implications for prognostication and trial design.

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J Crohns Colitis

A narrative systematic review and categorisation of outcomes in Inflammatory Bowel Disease to inform a Core Outcome Set for real-world evidence.

There is substantial variability in outcomes reporting and OMI types. Categorised outcomes and OMI from this review will inform a Delphi consensus on a COS for future RWE in IBD. Data collection standardisation may enhance the quality of RWE applied to decision-making.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Reaching people receiving opioid agonist therapy at community pharmacies with hepatitis C virus: An international randomised controlled trial.

Nurse-led PoC diagnosis in pharmacies made HCV care more accessible for OAT clients relative to conventional care. However, strategies to improve testing uptake are required.

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Response-guided long-term treatment of chronic hepatitis D patients with bulevirtide-Results of A "real world" Study.

Long-term BLV monotherapy is safe and effectively decreases HDV-RNA and ALT-even in patients with cirrhosis. The optimal duration of BLV treatment alone or in combination with PEG-IFN remains to be established. An algorithm for a response-guided BLV treatment approach is proposed.

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Stopping nucleot(s)ide analogues in non-cirrhotic HBeAg-negative chronic hepatitis B patients: HBsAg loss at 96weeks is associated with low baseline HBsAg levels.

Virological reactivation was very common after stopping NA therapy and occurred earlier after stopping TDF versus ETV. The majority of patients had ALT <2× ULN at week 96, but only one-third achieved disease remission and HBsAg loss was rare. Very low HBsAg levels at baseline were uncommon but predicted for HBsAg loss and disease remission.

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Am J Gastroenterol

CANNABIDIOL FOR FUNCTIONAL DYSPEPSIA WITH NORMAL GASTRIC EMPTYING: A RANDOMIZED, CONTROLLED TRIAL.

There were borderline CBD treatment-by-genotype interactions: rs806378 CNR1 with LPDS (p=0.06), and GE solids (p=0.12). Approved doses of CBD used off-label do not relieve FD with normal baseline GE solids or alter gastric motor functions and satiation. CBD treatment-by-gene interactions suggest potential benefit for postprandial distress with CNR1 rs806378 T allele.

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Digestive Health in Sexual and Gender Minority Populations.

It is expected al these factors would negatively impact digestive health as well. This review summarizes the impact of social determinants of health and discrimination on health care access, highlights important digestive diseases to consider in the SGM population, and offers solutions to improve and prioritize the health of these communities. We aim to draw attention to SGM-specific issues that impact gastrointestinal health and to spur research that is desperately lacking.

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Clin Gastroenterol Hepatol

A rectum-specific selective resection algorithm optimizes oncologic outcomes for large non-pedunculated rectal polyps.

A rectum-specific SRA optimizes oncologic outcomes for LNPRPs and mitigates the risk of piecemeal resection of cancers.

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Increasing Incidence of Pouchitis between 1996 and 2018: A Population-Based Danish Cohort Study.

This first population-based study demonstrated a 15% absolute and 38% relative increase in the incidence of pouchitis among patients undergoing surgery between 1996 and 2018, with the greatest cumulative incidence of pouchitis demonstrated in the most recent era (2015-2018). The striking increase in the incidence of pouchitis highlights the need for further research into causes and prevention of pouchitis.

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Outcome of Budd-Chiari Syndrome (BCS) patients treated with direct oral anticoagulants (DOACs) - an Austrian multicenter study.

DOACs seem to be effective and safe for long-term anticoagulation in patients with BCS, but confirmation by larger prospective studies is needed.

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Prospective Multicenter Study of the Primary Obesity Surgery Endoluminal (POSE2.0) Procedure for Treatment of Obesity.

POSE2.0 is an effective and durable endoscopic bariatric therapy which may influence physiologic pathways impacting satiety. Larger comparative studies are needed to further elucidate these initial findings.

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The Natural History of Asymptomatic Gallstones: a Longitudinal Study and Prediction Model.

The model demonstrated good discrimination (c-statistic = 0.70) and calibration. In general medical patients with AG, symptoms developed at approximately 2% per year. A predictive model with good calibration could be used to inform patients of their risk of SG.

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The Potential Role of Fatigue in Identifying Patients with NASH and Advanced Fibrosis who Experience Disease Progression.

Worse fatigue at baseline is associated with a higher risk of adverse clinical events in patients with NASH-related advanced fibrosis and cirrhosis.

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Endoscopy

Efficacy of a Computer Aided Detection (CADe) system in a FIT-based organized colorectal cancer screening program: a randomized controlled trial (AIFIT study).

Incorporating CADe significantly increases ADR and APC in the framework of a FIT-based CRC screening program. The impact of CADe appears to be consistent regardless of the endoscopist baseline ADR.

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Persistent contamination of a duodenoscope working channel in a non-clinical simulated ERCP setting.

The other two duodenoscopes only showed incidental contamination. Persistent contamination by Pa-type 1 was seen in one out of three duodenoscopes after exposure to supraphysiological levels of gut microorganisms. No clear explanation was found for this persistent contamination as exposure and handling were identical and no abnormalities of this particular duodenoscope were identified by borescope inspection.

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Gastroenterology

OPIOID EXPOSURE DIFFERENTIALLY IMPACTS ESOPHAGEAL BODY CONTRACTION OVER THE LOWER ESOPHAGEAL SPHINCTER.

Nearly 2 out of 3 patients with opioid exposure undergoing HRM have dysphagia and greater than 25% of them with dysphagia as the primary symptom have a diagnosis of either DES or HE. Opioid users with spastic disorders have higher symptom burden long-term compared to non-opioid users.

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Gastrointest Endosc

Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort.

Long-term programmatic screening and surveillance was safe, as major events were rare during follow-up. However, serious cardiopulmonary events were the most common major events. These results highlight the need for detailed assessments of comorbid conditions during routine clinical practice, which could help inform individual decisions regarding the utility of ongoing colonoscopy follow-up.

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Protein Biomarkers in Pancreatic Juice and Serum for Identification of Pancreatic Cancer.

High levels of serum CA19-9 and PJ-derived proteins are associated with PDAC. Prospective surveillance studies including individuals at risk of developing PDAC are required to validate these findings.

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Gut

Faecal occult blood loss accurately predicts future detection of colorectal cancer. A prognostic model.

Participants at lower versus higher risk of future AN or CRC can be accurately identified based on their age, sex and particularly, prior F-Hb concentrations. Risk stratification should be considered based on this information.

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Tacrolimus-binding protein FKBP8 directs myosin light chain kinase-dependent barrier regulation and is a potential therapeutic target in Crohn's disease.

Binding to FKBP8, which can be blocked by tacrolimus, is required for MLCK1 recruitment to intercellular junctions and downstream events leading to immune-mediated barrier loss. The observed increases in MLCK1 activity, MLCK1 localisation at cell junctions and perijunctional MLCK1-FKBP8 interactions in CD suggest that targeting this process may be therapeutic in human disease. These new insights into mechanisms of disease-associated barrier loss provide a critical foundation for therapeutic exploitation of FKBP8-MLCK1 interactions.

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Hepatology

NAFLD improves risk prediction of type 2 diabetes: with effect modification by sex and menopausal status.

The risks of T2D increased with NAFLD severity as assessed by serum fibrosis markers, and the highest relative excess risks were observed in premenopausal women. The addition of NAFLD to conventional risk factors improved risk prediction for incident T2D in both sexes, with a greater improvement in women than men. NAFLD, including more severe NAFLD, is a stronger risk factor for incident T2D in premenopausal women than in post-menopausal women or men; protection against T2D is lost in pre-menopausal women with NAFLD.

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Inflamm Bowel Dis

Long-Term Outcomes of the Excluded Rectum in Crohn's Disease: A Multicenter International Study.

From our entire cohort of 197 cases, 149 (75.6%) either ultimately lost their rectums or remained symptomatic with retained rectums, while only 28 (14.2%) of 197, and only 4 (5.9%) of 66 with initial perianal disease, were able to achieve reanastomosis without further problems. Four patients developed anorectal dysplasia or cancer. In this multicenter cohort of patients with CD who had fecal diversion, fewer than 15%, and only 6% with perianal disease, achieved reanastomosis without experiencing disease persistence.

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J Crohns Colitis

Association between inflammatory bowel disease and spondyloarthritis: findings from a nationwide study in Sweden.

In subgroup analyses, associations were most pronounced among patients with Crohn's disease [(OR=5.20; 95%CI:4.59-5.89), and (HR=10.55; 95%CI:9.16-12.15)] and paediatric onset IBD [(OR=3.63; 95%CI:2.35-5.59) and (HR=15.03; 95%CI:11.01-20.53)]. IBD patients more frequently experience SpA both before and after the diagnosis of IBD compared to the general population, supporting evidence of a shared pathophysiology. The variation in SpA comorbidity across IBD subtypes and age-groups, calls for targeted approaches to facilitate timely diagnosis and intervention.

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Bridging Fixed Dose to Body Weight-Based Regimen of Adalimumab in Pediatric Ulcerative Colitis Using a Pharmacometric Modeling Approach: Case Study with the Phase 3 ENVISION I Trial.

The population pharmacokinetic/pharmacodynamic model supports the appropriateness of the use of fixed dosing regimen in the pediatric ulcerative colitis population.

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Comparative risk of incident cancer in patients with Inflammatory Bowel Disease with prior non-digestive malignancy according to immunomodulator: a multicenter cohort study.

Incident-cancer-free survival rates were not different between patients receiving anti-TNF and those receiving vedolizumab (p=0.56). After adjustment, incidence rates were not different between patients receiving no immunomodulator, anti-TNF or vedolizumab. In this large multicenter cohort study, there was no difference of cancer incidence in IBD patients with prior non-digestive malignancy treated with vedolizumab or anti-TNF.

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Real-world endoscopic and histologic outcomes are correlated with ustekinumab exposure in patients with ulcerative colitis.

In this real-word cohort of refractory UC patients initiating UST, more than a third of the patients achieved histologic remission. A drug exposure-response relationship was observed for histo-endoscopic outcomes, with no added value of measuring tissue exposure given the strong correlation with serum exposure.

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J Hepatol

Gadoxetic Acid-enhanced MRI-derived Functional Liver Imaging Score (FLIS) and Spleen Diameter Predict Outcomes in ACLD.

The FLIS & SCCD are simple imaging markers providing complementary information for risk stratification in patients with compensated and decompensated ACLD.

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The recent outbreak of acute severe hepatitis in children of unknown origin - what is known so far.

Until now, seventeen children required liver transplantation, one died. Accordingly, the Centers for Disease Control and Prevention and the European Centre for Diseases Prevention and Control have both issued a warning on a hepatitis of unknown origin in children. This review focuses on the available information concerning this recent outbreak and introduces some of the discussed hypotheses for its development.

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Neurogastroenterol Motil

Antroduodenal motility recording identifies characteristic patterns in gastroparesis related to underlying etiology.

Antroduodenal motility patterns are different among GP etiologies. A dysmotility spectrum was identified with different patterns ranging from post-surgery GP to idiopathic and diabetic GP.

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Children with functional abdominal pain disorders successfully decrease FODMAP food intake on a low FODMAP diet with modest improvements in nutritional intake and diet quality.

The majority of children with FAPD on a dietitian-led LFD successfully decreased high FODMAP food intake. Children with FAPD on the LFD (vs. baseline) modestly improved micronutrient intake and diet quality.

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Latent class analysis does not support the existence of Rome IV functional bowel disorders as discrete entities.

The functional bowel disorders may be better characterized as a spectrum of IBS rather than separate disorders. Adopting this pragmatic stance may help to simply diagnosis, treatment, and recruitment of patients to research trials.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: liver and kidney injury from remdesivir-an issue not as much as its purpose.

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Editorial: safety in numbers-cycling of biologics does not increase risk of adverse outcomes.

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Editorial: what is normal function of a pelvic pouch?

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Incidence, pathophysiology, and implications of opioid-induced constipation and suggestions for patient-provider interactions.

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Peripherally acting mu-opioid receptor antagonists for the treatment of opioid-induced constipation.

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Gastroenterology

A Path Forward for Understanding and Addressing Multifaceted Pancreatic Cancer Disparities.

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Personalized Approach to the Post-Endoscopic Eradication Therapy Barrett's Esophagus Patient.

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PUCCINI Safety of Anti-TNF in the Perioperative Setting.

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Refining the Risk of Lymph Node Metastasis in T1 Colorectal Adenocarcinoma.

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Gastrointest Endosc

Second opinions foster better outcomes.

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Will robots take over our jobs as endoscopists?

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Hepatology

Endoplasmic Reticulum Stress in Liver Diseases.

It is well documented that ER stress contributes to the onset and progression of multiple hepatic pathologies including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), viral hepatitis, liver ischemia, drug toxicity, and liver cancers. Here, we review key studies dealing with the emerging role of ER stress and the UPR in the pathophysiology of liver diseases from cellular, murine, and human models. Specifically, we will summarize current available knowledge on pharmacological and non-pharmacological interventions that may be employed to target maladaptive UPR for the treatment of non-malignant liver diseases.

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J Hepatol

Normothermic liver machine perfusion as a dynamic platform for regenerative purposes. What does the future have in store for us?

With the current progress in experimental liver transplantation research, (long-term) normothermic machine perfusion may be used in the future as a dynamic platform for regenerative medicine approaches, enabling repair and regeneration of injured donor livers. Currently explored therapeutics such as defatting cocktails, ribonucleic acid interference, senolytics, and stem cell therapy may assist in the repair and/or regeneration of injured livers before transplantation. This review will provide a forecast of the future utility of normothermic machine perfusion for repair and regeneration of damaged donor livers to ultimately decrease the imbalance between donor liver demand and supply.

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Revealing anti-PD-1 resistance mechanisms in HCC: a path towards novel combination immunotherapies.

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The stigma of alcohol-related liver disease and its impact on healthcare.

Interventions to reduce ALD stigma and facilitate early help-seeking need to be developed and evaluated. CLINICAL TRIAL NUMBER: N. a.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: liver and kidney injury from remdesivir-an issue not as much as its purpose. Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: what is normal function of a pelvic pouch? Authors' reply.

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Letter: birth cohort pattern of Helicobacter pylori infection rates.

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Letter: paying attention to the comorbidities or extraintestinal complications in patients with inflammatory bowel disease during the COVID-19 pandemic.

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Letter: the effect of anti-COVID-19 treatment on the outcome of patients with inflammatory bowel disease.

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Clin Gastroenterol Hepatol

Cold snare polypectomy for large sessile polyp: Is it really ready?

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Gastroenterology

Proton pump inhibitor increasing the risk of infection and mortality in cirrhosis- need closer look!

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Gut

Genetically proxied ketohexokinase function and risk of colorectal cancer: a Mendelian randomisation study.

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Over-the-scope clips versus standard treatment.

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Withdrawal of the British Society of Gastroenterology IBD risk grid for COVID-19 severity.

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Hepatology

Letter to the Editor: Apples should be compared with apples.

Pubmed   Journal   ReadQx 

Letter to the Editor: Pitfalls in the outcomes differences between NAFLD and MAFLD.

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Response to Letters to the Editors.

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J Hepatol

Authors reply to the Letter to the Editor "Impact of MELD 30-allocation policy on liver transplant outcomes in Italy: Considerations".

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CHILDREN WITH AUTOIMMUNE LIVER DISEASE HAVE LIMITED ACCESS TO AGE-APPROPRIATE DRUG FORMULATIONS, RESULTS FROM A EUROPEAN SURVEY.

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HCC prediction post SVR in HCV patients: many tools yet limited generalizability!

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Methodological considerations regarding a gene signature to predict microvascular invasion in hepatocellular carcinoma.

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Reply to: "Protection against acetaminophen-induced liver injury with MG53: muscle-liver axis and necroptosis".

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Reply to: "The CRAFITY score: a promising prognostic predictor for patients with hepatocellular carcinoma treated with tyrosine kinase inhibitor and immunotherapy combinations".

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Response to 'Letter to the Editor' written by Dr. Isabelle Ollivier-Hourmand.

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Substantiating evidence for HCC risk stratification after cure of hepatitis C in patients with compensated advanced chronic liver disease.

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Others

all remaining publications eg case reports, images of the month, etc…

Am J Gastroenterol

Bleeding of GIST of the stomach due to tearing of the overlying epithelium by EUS-FNA.

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Ileocolonic intussusception due to hematoma after snare polypectomy.

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Motorized Spiral Enteroscope Guided Biliary Intervention for Treatment of Biliary Obstruction in Patient with HepaticoJejunostomy.

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Clin Gastroenterol Hepatol

Ileoileal intussusception caused by ileal neuroendocrine carcinoma.

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Interplay Between Dyslipidemia, Atherogenic Lipoproteins and Residual Atherogenic Risk in Liver Transplant Recipients.

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Massive Fecal Impaction.

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Endoscopy

A fully covered self-expandable metallic stent as a cystic-duct overtube facilitated stone removal from a gallbladder.

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Acute cholangitis after over-the-scope clip placement involving the duodenal papilla that was rescued by antegrade stenting via the percutaneous transhepatic biliary drainage route.

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Anterior pouch flexible endoscopic septal division: an alternative therapy for patients with a neopharyngeal pseudodiverticulum.

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Endoscopic retrieval of a blocked double-pigtail plastic biliary stent through an endoscopic ultrasound-guided gastrojejunostomy in a patient with gastric outlet obstruction.

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Endoscopic ultrasound-guided gallbladder drainage using a novel cautery-enhanced, endoscopist-deployed lumen-apposing metal stent.

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Endoscopic ultrasound-guided intra-afferent loop entero-enterostomy using a forward-viewing echoendoscope and insertion of a metal stent.

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Reopenable clip over line method for the closure of full-thickness defect after gastric endoscopic full-thickness resection.

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Technique for fine adjustment of snare size during endoscopic mucosal resection by a single endoscopist.

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Traction-assisted endoscopic full-thickness resection for a colonic submucosal tumor.

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Transesophageal endoscopic ultrasound-guided coil and cyanoacrylate treatment of challenging esophageal varices bleeding associated with CREST syndrome ulcerative esophagitis.

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Usefulness of a circumferential argon plasma coagulation probe in trimming a dislocated distal biliary metal stent.

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Gastroenterology

An Artificial Microbiome Consortium Prevents Recurrence of Clostridioidesdifficile Infection: Paving the Way for Fecal Microbiota Transplantation 2.0.

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Common genetic variants in the bile acid synthesis enzyme CYP7A1 are associated with severe primary bile acid diarrhea.

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Endoscopic Treatment of Obesity Using an Adjustable Intragastric Balloon.

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Expanding Links Between Gut Microbiota and Bowel Inflammation.

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Multi-omic Characterization of COVID Hepatitis.

Pubmed   Journal   ReadQx   PMC

Hepatology

The computer will see you now: Prediction of long-term survival in patients with cirrhosis.

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Inflamm Bowel Dis

Authors' Reply to "Immunogenicity of Tumor Necrosis Factor Antagonists and Effect of Dose Escalation on Anti-Drug Antibodies and Serum Drug Concentrations in Inflammatory Bowel Disease".

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Letter to the Editor in Response to "Immunogenicity of Tumor Necrosis Factor Antagonists and Effect of Dose Escalation on Anti-Drug Antibodies and Serum Drug Concentrations in Inflammatory Bowel Disease".

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Wernicke Encephalopathy in Ulcerative Colitis.

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J Hepatol

Hepatitis A: Current view of an ancient disease.

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NAFLD/NASH.

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